Provider Demographics
NPI:1831589241
Name:POLAN, ROSA MILLER (MD)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MILLER
Last Name:POLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4441 ATLANTA RD SE STE 319
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6443
Mailing Address - Country:US
Mailing Address - Phone:770-792-6262
Mailing Address - Fax:678-842-5558
Practice Address - Street 1:4441 ATLANTA RD SE STE 319
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6443
Practice Address - Country:US
Practice Address - Phone:770-792-6262
Practice Address - Fax:678-842-5558
Is Sole Proprietor?:No
Enumeration Date:2015-01-24
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125.070230207V00000X
GA98067207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology